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Tuesday, May 31, 2016

The European Respiratory Society hosted a World No Tobacco Day event Plain-packaging to protect our youth: “Progress made, challenges ahead”
in collaboration with the European Network for Smoking Prevention
(ENSP) to highlight the research-backed benefits of plain packaging on
tobacco products and to celebrate the countries who have led the way –
hoping to encourage remaining countries to follow their lead.

The event took place at the European Parliament in Brussels on
31 May, 2016 and supports the theme announced by the World Health
Organisation (WHO) for this year’s World No Tobacco Day campaign, which
is: “Get ready for plain-packaging”. It is also timely alongside the
introduction of plain packaging on tobacco products in the U.K, Ireland
and France.

Sunday, May 29, 2016

Tobacco
packaging is a mobile billboard promoting consumption of tobacco
products. If you strip back the decoration, gloss and misleading
elements of tobacco packaging, you are left with little more than a box
of deadly, addictive products that kill approximately 6 million people a
year and harm the health of many more. Plain packaging helps reveal the
grim reality of tobacco products.For World No Tobacco Day on 31
May 2016, WHO and the Secretariat of the WHO Framework Convention on
Tobacco Control are calling on countries to get ready for plain (also
called standardized) packaging of tobacco products.

The aims of plain packaging are to:

reduce the attractiveness of tobacco products;

eliminate the effect of tobacco packaging as a form of advertising and promotion;

eliminate package design techniques that may suggest that some products are less harmful than others; and

increase the noticeability and effectiveness of health warnings.

The
results of experimental studies, surveys and focus-group studies show
that plain packaging achieves its objectives. WHO recommends that plain
packaging be used as part of a comprehensive approach to tobacco
control, which also includes comprehensive bans on tobacco advertising,
promotion and sponsorship and other tobacco packaging and labelling
measures, such as health warnings.

Saturday, May 28, 2016

Menthol is a flavouring agent commonly used in cigarettes and other
tobacco products. Menthol cigarettes are used more frequently by younger
smokers, women and ethnic minorities, and their use facilitates both
initiation and continued smoking, leading to addiction. These issues
have raised global concern.

To address this public health issue, the WHO Study
Group on Tobacco Product Regulation (TobReg) has prepared this advisory
note on menthol, which synthesizes recent studies on the prevalence and
health effects of menthol in tobacco products. It provides
evidence-based conclusions and recommendations for policy-makers and
regulators, including a ban on menthol (and its analogues, derivatives
and precursors) in cigarettes.

Wednesday, May 25, 2016

The morbidity and mortality of chronic obstructive pulmonary
disease (COPD) continues in an uninterrupted fashion; current treatment
options are limited, and there is no cure. Failure to diagnose COPD
early, poor correlation of airflow obstruction with the extent and type
of structural impairment, the number of comorbid conditions, and the
lack of an adequate animal model for COPD account for our current
inability to transform COPD treatment. Fortunately the tide is beginning
to turn.

The medical research community has recognized these problems
and has embarked on multiple paths of scientific inquiry to understand
COPD pathogenesis, the clinical phenotypes, and treatments that are
truly novel by using compounds that inhibit pathways of lung injury and
aberrant responses of repair. The following are examples of the research
work conducted on COPD in 2015 that attempt to address many of the
questions that need to be answered to achieve the common goal of not
only improving the care of patients with COPD but also curing them of
this devastating disease.

Saturday, May 21, 2016

Back in 2012, researchers from the University of Washington (UW)
introduced a new tool - SpiroSmart for those suffering from respiratory problems in
the form of a smartphone app
that measures lung health. While this may have improved access to care
for many, it didn't mean a great deal to those without a smartphone. The
team is now looking to expand the reach of its technology by designing a
system that allows patients to call in from anywhere in the world, from
any phone, to gauge the health of their lungs.

Chronic lung conditions like asthma or COPD can require
careful monitoring, often involving regular visits to the clinic. This
mightn't be too problematic if you live in a big, modern city, but in
developing countries a trip to the doctor can mean hours or even days on
the road.

The idea is that users of the SpiroCall service call a 1-800 number from
anywhere in the world and perform a hard exhale, just as they would
when using a commercial spirometer. The audio is collected and relayed
to a server, where the team's algorithms translate the breath into a
reading of the patient's lung function.

Friday, May 20, 2016

BackgroundThe wide availability of long-acting muscarinic antagonist
(LAMA)/long-acting β2-agonist (LABA) fixed-dose combinations (FDCs) in
the absence of head-to-head comparative pragmatic trials makes it
difficult to choose which combination should be used. Therefore, we
carried out a systematic review with meta-analysis that incorporated the
data from trials lasting at least 3 months to evaluate the
effectiveness of LAMA/LABA FDCs for COPD treatment.

MethodsRandomized controlled trials were identified by searching
different databases of published and unpublished trials. We aimed to
assess the influence of LAMA/LABA combinations on trough FEV1,
transitional dyspnea index, St. George's Respiratory Questionnaire, and
cardiac safety vs monocomponents.ResultsFourteen papers and one congress abstract with 23,168
patients with COPD (combinations, n = 10,328; monocomponents, n =
12,840) were included in this study. Our results showed that all
LAMA/LABA combinations were always more effective than the LAMA or LABA
alone in terms of the improvement in trough FEV1. Although there was not
significant difference among LAMA/LABA combinations, we identified a
gradient of effectiveness among the currently available LAMA/LABA FDCs.
LAMA/LABA combinations also improved both transitional dyspnea index and
St. George's Respiratory Questionnaire scores, but did not increase the
cardiovascular risk when compared with monocomponents.ConclusionsThe gradient of effectiveness emerging from this
meta-analysis is merely a weak indicator of possible differences between
the various LAMA/LABA FDCs. Only direct comparisons will document if a
specific LAMA/LABA FDC is better than the other. In the meanwhile, we
believe it is only proper to consider that dual bronchodilation is
better than a LAMA or a LABA alone, regardless of the drugs used.full text from Chest: http://journal.publications.chestnet.org/article.aspx?articleid=2499555&resultClick=3

This year, in celebration of International Clinical Trials Day
on 20 May, BioMed Central has put together a timeline of the stages of
conducting a clinical trial. We’ll reveal more stages throughout the
week, in the lead up to the day itself. We’ve invited some of the greats
in the field to comment on why the stage is important to a trial, what
should be considered and why it should be considered at that point in
the trial timeline.

It all began with James Lind
in the 1740s, and his observation that British fleet scurvy caused more
deaths than in French and Spanish fleets combined. He hypothesized that
the citrus fruit on board the latter were minimizing their risk so on
May 20, 1747, took 12 patients on board the British Salisbury and tested
whether these fruit would alleviate their scurvy symptoms.

This gave rise to one of the first ever recorded clinical trials and
why we celebrate International Clinical Trials Day globally on May 20.

Since Lind’s pioneering work 269 years ago, medical research has come a long way.

Wednesday, May 18, 2016

Background
We assessed the relationship of body mass index (BMI), smoking,
drinking and solid fuel use (r; SFU), and the individual
and combined effects of these
factors on wheezing symptoms (WS) and on diagnosed asthma (DA).

Methods We
analysed 175 000 individuals from 51 nationally representative surveys,
using self-reports of WS and DA as the measures
of asthma. The fixed-effects and
random-effects estimates of the pooled ORs between asthma and
underweight (BMI <18.5 kg/m2), obesity (BMI ≥30 kg/m2), smoking, drinking and SFU were reported.

Results
The pooled risks of all individual risk factors were significantly
associated with WS and DA (with the exception of current
smoking with DA in women and SFU
with DA in both genders). Stronger dose–response relationships were seen
in women for smoking
amounts and duration; BMI showed
stronger quadratic relationships. The combined risks were generally
larger in women than
in men, with significant risks for
underweight (OR=2.73) as well as obese (OR=2.00) smokers for WS (OR=2.13
and OR=1.58 for
DA, respectively). The magnitude of
the combined effects from low/high BMI, smoking and drinking were also
consistently higher
among women than among men in WS and
DA. SFU among underweight smokers also had positive association with WS
(men and women)
and DA (women).

Conclusions BMI, smoking, drinking and SFU—in combination—are associated with double or triple the risk of development of asthma. These
risk factors might help explain the wide variation in asthma burden across countries.

Tuesday, May 17, 2016

Dear Respiratory friends, we are happy to present you exciting story of discovery of roflumilast for the treatment of COPD by great Italian team: Mario Cazzola, Luigino Calzetta, Paola Rogliani & Maria Gabriella Matera.

Introduction: Cyclic adenosine
monophosphate (cAMP) phosphodiesterase (PDE)4 is an intracellular target
that can be exploited to the treat chronic obstructive pulmonary
disease (COPD), given that it is expressed in all inflammatory cells
implicated in this inflammatory airways disease. At the present time,
roflumilast is the only PDE4 inhibitor that has received regulatory
approval for use in patients with COPD.

Areas covered:
The preclinical, clinical and post-marketing development of roflumilast
is described. Furthermore, a critical analysis of the clinical data and
positioning of this drug is undertaken in this review

Expert opinion:
The identification of a subset of COPD patients, namely those suffering
from severe airflow obstruction with symptoms of chronic cough and
sputum and a history of previous exacerbations, as a specific target for
roflumilast with the goal of reducing exacerbations, was entirely
casual because the delineation of a “chronic bronchitis” responder group
was clearly a post-hoc finding. However, it was useful to design
prospective clinical trials that demonstrated reduced exacerbations in
this specific subset of patients towards whom roflumilast therapy is now
targeted. However, these pivotal trials still do not provide more
accurate identification of the type of exacerbation to be treated by
roflumilast. The identification of the right biological COPD
exacerbation phenotype and/or the right clinical COPD phenotype are the
only means that could justify the use of roflumilast as a first line
anti-inflammatory therapeutic approach.

Sunday, May 15, 2016

Dear Respiratory Friends great news come from NEJM about dual bronchodilators in COPD!

Most guidelines recommend either a long-acting
beta-agonist (LABA) plus an inhaled glucocorticoid or a long-acting
muscarinic antagonist (LAMA) as the first-choice treatment for patients
with chronic obstructive pulmonary disease (COPD) who have a high risk
of exacerbations. The role of treatment with a LABA–LAMA regimen in
these patients is unclear.

Methods

We
conducted a 52-week, randomized, double-blind, double-dummy,
noninferiority trial. Patients who had COPD with a history of at least
one exacerbation during the previous year were randomly assigned to
receive, by inhalation, either the LABA indacaterol (110 μg) plus the
LAMA glycopyrronium (50 μg) once daily or the LABA salmeterol (50 μg)
plus the inhaled glucocorticoid fluticasone (500 μg) twice daily. The
primary outcome was the annual rate of all COPD exacerbations.

Results

A
total of 1680 patients were assigned to the indacaterol–glycopyrronium
group, and 1682 to the salmeterol–fluticasone group.
Indacaterol–glycopyrronium showed not only noninferiority but also
superiority to salmeterol–fluticasone in reducing the annual rate of all
COPD exacerbations; the rate was 11% lower in the
indacaterol–glycopyrronium group than in the salmeterol–fluticasone
group (3.59 vs. 4.03; rate ratio, 0.89; 95% confidence interval [CI],
0.83 to 0.96; P=0.003). The indacaterol–glycopyrronium group had a
longer time to the first exacerbation than did the
salmeterol–fluticasone group (71 days [95% CI, 60 to 82] vs. 51 days
[95% CI, 46 to 57]; hazard ratio, 0.84 [95% CI, 0.78 to 0.91],
representing a 16% lower risk; P<0.001). The annual rate of moderate
or severe exacerbations was lower in the indacaterol–glycopyrronium
group than in the salmeterol–fluticasone group (0.98 vs. 1.19; rate
ratio, 0.83; 95% CI, 0.75 to 0.91; P<0.001), and the time to the
first moderate or severe exacerbation was longer in the
indacaterol–glycopyrronium group than in the salmeterol–fluticasone
group (hazard ratio, 0.78; 95% CI, 0.70 to 0.86; P<0.001), as was the
time to the first severe exacerbation (hazard ratio, 0.81; 95% CI, 0.66
to 1.00; P=0.046). The effect of indacaterol–glycopyrronium versus
salmeterol–fluticasone on the rate of COPD exacerbations was independent
of the baseline blood eosinophil count. The incidence of adverse events
and deaths was similar in the two groups. The incidence of pneumonia
was 3.2% in the indacaterol–glycopyrronium group and 4.8% in the
salmeterol–fluticasone group (P=0.02).

Conclusions

Indacaterol–glycopyrronium
was more effective than salmeterol–fluticasone in preventing COPD
exacerbations in patients with a history of exacerbation during the
previous year.

Saturday, May 7, 2016

British well known national daily newspaper the Guardian wrotes last week: "The idea of a supremely fit professional cyclist like Simon Yates having to occasionally reach for an inhaler to ward off a wheeze might seem anomalous. But asthma is surprisingly common among some elite athletes.

A handful have classic asthma, the usually allergy-triggered
constriction of the bronchial tubes that tends to begin in childhood.

Much more common in sport is exercise-induced asthma, or EIA, in
which rapid and heavy breathing causes the same symptoms. The effect can
be exacerbated by atmospheric conditions, which means some sportspeople
tend to suffer more than others.

Friday, May 6, 2016

Dear Respiratory friends we are happy to invite you on Great Respiratory event organized by our friends in Georgia!!! On behalf of the Organizing Committee of the Georgian Respiratory Association 5th
International Congress, we would like to extend our warmest welcome to
you all, to participate in this international event, which will be held
in Sheraton Batumi Hotel, Batumi, Georgia, on 23-25June, 2016.

This is 5th
congress of the Georgian Respiratory Association, organizing with
collaboration of the Government of Ajara Autonomous Republic, Tbilisi
State Medical University, EVEX Medical Corporation, Georgian
International Medical and Public Health Association(GIMPHA).

Georgian
Respiratory Association with about 1000 members representing various
disciplines of respiratory medicine together with world-renowned experts
from Europe, America and Asia make this gathering a unique scientific
event not only in Georgia but also in the region.

The
Scientific Committee is planning a very comprehensive program catering
for all specialties of respiratory medicine that will deliver state of
the art lectures, update presentations, postgraduate courses, and
abstract presentations. The program covers all fields related to
respiratory medicine including Asthma and Allergy, RespiratoryCritical
Care Medicine, Lung Cancer, Pulmonary Infections, Thoracic Imaging,
Thoracic Surgery, Thoracic Oncology, Rare Lung Diseases, COPD,
Interventional Bronchoscopy, and Pediatric Pulmonology.

The
pharmaceutical industry is also committed in their support of our
congress that will host a large exhibit area and many opportunities to
share their products and current information with the attendees.

Like
previous years, the Congress Organizing Committee is working hard to
make this event a stimulating occasion both scientifically and socially.
Undoubtedly, it will be a great opportunity to see other colleagues and
friends and to benefit from the wide spectrum of medical topics to be
discussed in this congress.

Besides
our extensive scientific meetings, we will have the chance of meeting
with friends old and new, with an enjoyable social program. We will meet
you in the glamorous city of Batumi, a fast growing beautiful city with
many attractions and rich heritage.

Please be prepared to meet the Georgian unique
culture, which has evolved over the countrys long history, providing it
with a unique national culture and a strong literary tradition based on
the Georgian language and
alphabet. Please get ready for the excitement and new different life
that Georgia and Batumi can offer you. Please be ready for wonderful
Georgian food and taste Georgian wine.

For these reasons, we look forward to seeing you in Georgia, so please mark your calendar and plan to join us.

Thursday, May 5, 2016

Each year on May 5, pulmonary hypertension organizations and groups
around the world participate in World Pulmonary Hypertension Day
activities to raise awareness of this often-misdiagnosed disease and
celebrate the lives of people living with PH. World PH Day brings global
attention to the importance of improving the quality of life and life
expectancy of the more than 25 million people living with PH worldwide.

Objectives

During the celebration of World PH Day, pulmonary hypertension organizations work to:

Increase awareness and disseminate knowledge of the disease to
facilitate early diagnosis. Early diagnosis is important in decreasing
premature PH-related deaths.

Promote access to specific healthcare and treatments that increase quality of life and life expectancy.

Promote the concept of treating PH patients as a whole, which includes treating their physical, psychological and social issues.

Unify international criteria for the recognition of Centers of Excellence in PH.

Promote research that will help find the cure for pulmonary hypertension.

Members of the pulmonary hypertension community worldwide also
organize and take part in a wide variety of awareness-raising events,
actions and celebrations.

History

In 2012, a program and a scientific symposium were held in Madrid,
Spain as the first World PH Day celebration. The day was officially
endorsed by 22 patient associations, 10 rare and affiliated disease
organizations, and 8 scientific societies.

May 5 was originally chosen as World PH Day because it is the
anniversary of the first child's death in Spain from pulmonary
hypertension as a result of toxic rapeseed oil more than 30 years ago.
This year, the May 5 date was upheld as World PH Day by popular
consensus, and events are planned worldwide.

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

Guidelines summarize and evaluate all available evidence on a particular
issue at the time of the writing process, with the aim of assisting
health professionals in selecting the best management strategies for an
individual patient with a given condition, taking into account the
impact on outcome, as well as the risk–benefit ratio of particular
diagnostic or therapeutic means. Guidelines and recommendations should
help health professionals to make decisions in their daily practice.
However, the final decisions concerning an individual patient must be
made by the responsible health professional(s) in consultation with the
patient and caregiver as appropriate.

Tuesday, May 3, 2016

World Asthma Day is a big event celebrated all over the world by the
people to increase the awareness among public worldwide about the
precautions and preventions of the asthma. This event is annually
organized on international level by the GINA (Global Initiative for
Asthma) in order to increase the asthma awareness all around the world.
It is celebrated on annual basis at 1st Tuesday of the May
month. World Asthma Day celebration was first started celebrating in the
year 1998 by the GINA in more than 35 countries after its first “World
Asthma Meeting” in the Barcelona, Spain.

The 2016 update of the Global Strategy for Asthma Management and Prevention incorporates new scientific information about asthma based
on a review of recent scientific literature by an international panel
of experts on the GINA Science Committee. This
comprehensive and practical resource about one of the most common
chronic lung diseases worldwide contains extensive citations from the
scientific literature and forms the basis for other GINA documents and
programs.

Link for free download of the 2016 update of the Global Strategy for Asthma Management and Prevention:

Objectives: The specific goals of this
Research Statement are to appraise the evidence regarding whether
long-term adverse neurocognitive and cardiovascular outcomes are
attributable to mild OSA in adults, evaluate whether or not treatment of
mild OSA is effective at preventing or reducing these adverse
neurocognitive and cardiovascular outcomes, delineate the key research
gaps, and provide direction for future research agendas.

Methods:
Literature searches from multiple reference databases were performed
using medical subject headings and text words for OSA in adults as well
as by hand searches. Pragmatic systematic reviews of the relevant body
of evidence were performed.

Results: Studies were
incongruent in their definitions of “mild” OSA. Data were inconsistent
regarding the relationship between mild OSA and daytime sleepiness.
However, treatment of mild OSA may improve sleepiness in patients who
are sleepy at baseline and improve quality of life. There is limited or
inconsistent evidence pertaining to the impact of therapy of mild OSA on
neurocognition, mood, vehicle accidents, cardiovascular events, stroke,
and arrhythmias.

Conclusions: There is
evidence that treatment of mild OSA in individuals who demonstrate
subjective sleepiness may be beneficial. Treatment may also improve
quality of life. Future research agendas should focus on clarifying the
effect of mild OSA and impact of effective treatment on other
neurocognitive and cardiovascular endpoints as detailed in the document.

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